Materiały źródłowe

• #1 Nightmare Disorder: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/914428-overview

  Nightmare disorder is defined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) as repeated awakenings with recollection of terrifying dreams, usually involving threats to survival, safety or physical integrity. […] Nightmare disorder is defined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) as repeated awakenings with recollection of terrifying dreams, usually involving threats to survival, safety or physical integrity. […] Nightmares are defined as recurrent episodes of awakening from sleep with recall of intensely disturbing dream mentation, usually involving fear or anxiety, but also anger, sadness, disgust, and other dysphoric emotions. […] Sleep is divided into 2 distinct states: rapid eye movement (REM) and nonrapid eye movement (non-REM). REM and non-REM sleep alternate in 90- to 100-minute cycles. REM sleep is characterized by EEG activity similar to a wakeful pattern. In older children and adults, 75% of sleep is non-REM sleep, which consists of 4 stages.

• #2 Nightmare Disorder: Symptoms, Causes, Treatment

  https://www.verywellmind.com/nightmare-disorder-definition-symptoms-causes-treatment-5220095

  Nightmare disorder (ND) is a sleep disorder in which a person consistently experiences frightening, vivid or disturbing dreams, defined as nightmares, that suddenly wakes them. […] Nightmare disorder is considered a parasomnia, a type of sleep disorder that interferes with a persons sleep by creating abnormal or undesirable experiences. […] Nightmares only occur during rapid eye movement (REM) sleep, which means theyre more likely to make an appearance after entering into a deeper sleep. […] Post-traumatic stress disorder (PTSD) has been shown to be greatly connected to nightmare disorder. A review of different literature included many research studies that found correlations between nightmares and PTSD. […] One study, in particular, discovered that nightmares after a traumatic event can trigger PTSD. It was determined that a history of nightmares can produce a greater chance of developing PTSD.

• #3 Nightmare Disorder: What It Is, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/24464-nightmare-disorder

  Nightmare disorder is a pattern of repeated frightening and vivid dreams that cause significant distress or impaired functioning. […] Researchers don’t know what exactly causes nightmares and nightmare disorder, but they have multiple theories. […] One theory is that nightmare disorder may be influenced by increased hyperarousal that builds during the day and remains at night. Hyperarousal may make certain areas of your brain overactive while you sleep, causing nightmares. […] Another theory involves a concept called fear extinction. According to the impaired fear extinction theory, people with nightmare disorder continue to activate fear memories during sleep. The theory states that people who have difficulty regulating their emotions in stressful situations and tend to react negatively to stress are more prone to nightmares.

• #4 Aetiology and treatment of nightmare disorder: State of the art and future perspectives

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6850667/

  This consensus paper provides an overview of the state of the art in research on the aetiology and treatment of nightmare disorder and outlines further perspectives on these issues. […] Chronic nightmares develop through the interaction of elevated hyperarousal and impaired fear extinction. […] The aetiology of nightmare disorder may be influenced by increased hyperarousal that accumulates during the day and is maintained at night. Elevated hyperarousal is discussed as a central pathophysiological factor in PTSD, but also in insomnia disorder. […] Although normal sleep and dreaming may enable fear extinction through a process of recombining fearful memories with novel and dissociated contexts, individuals with nightmare disorder continue to activate arousing memory fragments during sleep, reinforcing fear memories.

• #5 Nightmare Disorder: Symptoms, Causes, and Treatment | Doctor

  https://patient.info/doctor/nightmare-disorder

  Several research groups have proposed that nightmare disorders result from increased hyperarousal and impaired fear extinction. […] Hyperarousal may develop during the day and be maintained at night. Hyperarousal is central to the pathophysiology of PTSD and insomnia. […] Normal sleep and dreaming may lead to fear extinction by recombining fear-inducing memories with novel and dissociated contexts. However, people with nightmare disorder continue to activate distressing and arousing memory fragments during sleep, reinforcing memories of fear. […] It is theorised that recurrent nightmare elements may then become condensed into a 'nightmare script’, where dream elements trigger the nightmare to occur. Nightmares may, therefore, persist long after the initial stressor has subsided.

• #6 Nightmare Disorder and Effect on the Brain – DRAFT ONLY Cognitive Neuroscience

  https://caul-cbua.pressbooks.pub/cogneuro/chapter/nightmare-disorder-and-effect-on-the-brain/

  The aetiology of nightmare disorder is still being researched, the leading theories suggest hyperarousal and impaired fear extinction are what causes the disorder. […] Hyperarousal is also a primary pathophysiological factor in other disorders, such as PTSD and insomnia. […] Healthy sleepers with normally functioning fear extinction are able to recombine negative memories with novel and dissociated contexts. […] People with high afferent load and afferent distress are more likely to have impaired fear extinction, and people with impaired fear extinction are more likely to have nightmares that constitute a clinical problem such as nightmare disorder. […] This suggests that the hyperarousal experienced by people with nightmare disorder, as well as PTSD, is linked to the high activation of the inferior parietal lobule.

• #7 Nightmare Disorder: What It Is, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/24464-nightmare-disorder

  Nightmare disorder is a pattern of repeated frightening and vivid dreams that cause significant distress or impaired functioning. […] Researchers don’t know what exactly causes nightmares and nightmare disorder, but they have multiple theories. […] One theory is that nightmare disorder may be influenced by increased hyperarousal that builds during the day and remains at night. Hyperarousal may make certain areas of your brain overactive while you sleep, causing nightmares. […] Another theory involves a concept called fear extinction. According to the impaired fear extinction theory, people with nightmare disorder continue to activate fear memories during sleep. The theory states that people who have difficulty regulating their emotions in stressful situations and tend to react negatively to stress are more prone to nightmares.

• #8 Aetiology and treatment of nightmare disorder: State of the art and future perspectives

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6850667/

  This consensus paper provides an overview of the state of the art in research on the aetiology and treatment of nightmare disorder and outlines further perspectives on these issues. […] Chronic nightmares develop through the interaction of elevated hyperarousal and impaired fear extinction. […] The aetiology of nightmare disorder may be influenced by increased hyperarousal that accumulates during the day and is maintained at night. Elevated hyperarousal is discussed as a central pathophysiological factor in PTSD, but also in insomnia disorder. […] Although normal sleep and dreaming may enable fear extinction through a process of recombining fearful memories with novel and dissociated contexts, individuals with nightmare disorder continue to activate arousing memory fragments during sleep, reinforcing fear memories.

• #9 Nightmare Disorder: Symptoms, Causes, and Treatment | Doctor

  https://patient.info/doctor/nightmare-disorder

  Several research groups have proposed that nightmare disorders result from increased hyperarousal and impaired fear extinction. […] Hyperarousal may develop during the day and be maintained at night. Hyperarousal is central to the pathophysiology of PTSD and insomnia. […] Normal sleep and dreaming may lead to fear extinction by recombining fear-inducing memories with novel and dissociated contexts. However, people with nightmare disorder continue to activate distressing and arousing memory fragments during sleep, reinforcing memories of fear. […] It is theorised that recurrent nightmare elements may then become condensed into a 'nightmare script’, where dream elements trigger the nightmare to occur. Nightmares may, therefore, persist long after the initial stressor has subsided.

• #10 Nightmares | MedLink Neurology

  https://www.medlink.com/articles/nightmares

  Findings of a sleep-lab study on participants with frequent nightmares indicate that they had increased high-frequency spectral power during NREM and pre-REM periods, as well as relatively reduced slow frequency and increased fast frequency spectral power across pre- and post-REM periods as compared with healthy controls. […] This combination of reduced sleep-protective activity and increased hyperarousal suggests an imbalance between sleep regulatory and wake-promoting systems in participants with frequent nightmares. […] Findings of another study do not support the concept that abnormal REM sleep plays a role in the pathophysiology of frequent nightmares; rather, the altered REM sleep in nightmare disorder could have been confounded with comorbid pathologies. […] Furthermore, it is suggested that there is altered autonomic activity (parasympathetic) during sleep among nightmare recallers. […] A study has shown a significant difference in heart rate of nightmare recallers compared to healthy control subjects that occurs only during the sleep and not during restful wakefulness.

• #11 The pathophysiology of nightmare disorder: Signs of impaired sleep regulation and hyperarousal

  https://ouci.dntb.gov.ua/en/works/4kQzNj09/

  The pathophysiology of nightmare disorder: Signs of impaired sleep regulation and hyperarousal […] Nightmare disorder is characterized by dysfunctional emotion regulation and poor subjective sleep quality reflected in pathophysiological features such as abnormal arousal processes and sympathetic influences. […] Our findings indicate that NM participants had increased high-frequency spectral power during NREM and pre-REM periods, as well as relatively reduced slow frequency and increased fast frequency spectral power across pre-and post-REM periods. This combination of reduced sleep-protective activity and increased hyperarousal suggests an imbalance between sleep regulatory and wake-promoting systems in NM participants. […] Dysfunctional parasympathetic regulation, especially before and during rapid eye movement (REM) phases, is assumed to alter heart rate (HR) and its variability (HRV) of frequent nightmare recallers (NM). […] In conclusion, trait-like autonomic changes during sleep and state-like autonomic responses to emotion-evoking pictures indicate parasympathetic dysregulation in NMs.

• #12 Aetiology and treatment of nightmare disorder: State of the art and future perspectives

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6850667/

  This consensus paper provides an overview of the state of the art in research on the aetiology and treatment of nightmare disorder and outlines further perspectives on these issues. […] Chronic nightmares develop through the interaction of elevated hyperarousal and impaired fear extinction. […] The aetiology of nightmare disorder may be influenced by increased hyperarousal that accumulates during the day and is maintained at night. Elevated hyperarousal is discussed as a central pathophysiological factor in PTSD, but also in insomnia disorder. […] Although normal sleep and dreaming may enable fear extinction through a process of recombining fearful memories with novel and dissociated contexts, individuals with nightmare disorder continue to activate arousing memory fragments during sleep, reinforcing fear memories.

• #13 Nightmare Disorder: Symptoms, Causes, and Treatment | Doctor

  https://patient.info/doctor/nightmare-disorder

  Several research groups have proposed that nightmare disorders result from increased hyperarousal and impaired fear extinction. […] Hyperarousal may develop during the day and be maintained at night. Hyperarousal is central to the pathophysiology of PTSD and insomnia. […] Normal sleep and dreaming may lead to fear extinction by recombining fear-inducing memories with novel and dissociated contexts. However, people with nightmare disorder continue to activate distressing and arousing memory fragments during sleep, reinforcing memories of fear. […] It is theorised that recurrent nightmare elements may then become condensed into a 'nightmare script’, where dream elements trigger the nightmare to occur. Nightmares may, therefore, persist long after the initial stressor has subsided.

• #14 Nightmare Disorder and Isolated Sleep Paralysis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8116464/

  Nightmare disorder can cause insomnia due to fear of falling asleep through dread of nightmare occurrence. Hyperarousal and impaired fear extinction are involved in nightmare generation, as well as brain areas involved in emotion regulation. Nightmare disorder is particularly frequent in psychiatric disorders and posttraumatic stress disorder. […] Nightmare disorder might also involve disturbance of fear extinction, which should be enabled by normal sleep and dreaming in patients with nightmare disorders. Both hyperarousal and impaired fear extinction, possibly facilitated by traumatic experiences, childhood adversity, and other trait susceptibilities, as well as physical and cognitive factors, contribute to the formation of a nightmare script, which is then thought to be replayed over and over and to generate the nightmare distress.

• #15

  https://link.springer.com/article/10.1007/s13311-020-00966-8

  Nightmare disorder can cause insomnia due to fear of falling asleep through dread of nightmare occurrence. […] Hyperarousal and impaired fear extinction are involved in nightmare generation, as well as brain areas involved in emotion regulation. […] Nightmare disorder might also involve disturbance of fear extinction, which should be enabled by normal sleep and dreaming in patients with nightmare disorders. […] Both hyperarousal and impaired fear extinction, possibly facilitated by traumatic experiences, childhood adversity, and other trait susceptibilities, as well as physical and cognitive factors, contribute to the formation of a nightmare script, which is then thought to be replayed over and over and to generate the nightmare distress. […] Several models have been developed to explain the pathophysiology of nightmare disorder. These include a neurocognitive model by Levin and Nielsen, which proposes that nightmares reflect disturbed emotion regulation and involve the amygdala, medial, prefrontal cortex, hippocampus, and anterior cingulate cortex. […] The pathogenesis of sleep paralysis may involve variations in circadian rhythm genes. […] Predisposing factors include sleep deprivation, irregular sleepwake schedules, and jetlag.

• #16 Nightmare Disorder: Symptoms, Causes, Treatment, and Prevention

  https://psychcentral.com/disorders/nightmare-disorder-symptoms

  Nightmare disorder, also called dream anxiety disorder, is a rare type of sleep-related disorder (parasomnia) affecting about 4% of adults, causing distress and sleep problems. […] Research from 2019 suggests nightmare disorder may be influenced by hyperarousal that builds during the day and continues throughout the night. Nightmare disorder may also be associated with fear-based memories that lie dormant during waking hours and become aroused during sleep. […] In addition, the theoretical framework called the cognitive model of recurrent dreams poses that persistent nightmares are caused by loops or scripts of replaying patterns, even when stress from the original event has faded from regular waking consciousness. The model explains that a nightmare script becomes activated in response to dream elements that resemble the original stressor and is perpetuated again and again.

• #17 Nightmare Disorder: Symptoms, Causes, and Treatment | Doctor

  https://patient.info/doctor/nightmare-disorder

  Several research groups have proposed that nightmare disorders result from increased hyperarousal and impaired fear extinction. […] Hyperarousal may develop during the day and be maintained at night. Hyperarousal is central to the pathophysiology of PTSD and insomnia. […] Normal sleep and dreaming may lead to fear extinction by recombining fear-inducing memories with novel and dissociated contexts. However, people with nightmare disorder continue to activate distressing and arousing memory fragments during sleep, reinforcing memories of fear. […] It is theorised that recurrent nightmare elements may then become condensed into a 'nightmare script’, where dream elements trigger the nightmare to occur. Nightmares may, therefore, persist long after the initial stressor has subsided.

• #18 Nightmare Disorder and Isolated Sleep Paralysis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8116464/

  Several models have been developed to explain the pathophysiology of nightmare disorder. These include a neurocognitive model by Levin and Nielsen, which proposes that nightmares reflect disturbed emotion regulation and involve the amygdala, medial, prefrontal cortex, hippocampus, and anterior cingulate cortex.

• #19

  https://link.springer.com/article/10.1007/s13311-020-00966-8

  Nightmare disorder can cause insomnia due to fear of falling asleep through dread of nightmare occurrence. […] Hyperarousal and impaired fear extinction are involved in nightmare generation, as well as brain areas involved in emotion regulation. […] Nightmare disorder might also involve disturbance of fear extinction, which should be enabled by normal sleep and dreaming in patients with nightmare disorders. […] Both hyperarousal and impaired fear extinction, possibly facilitated by traumatic experiences, childhood adversity, and other trait susceptibilities, as well as physical and cognitive factors, contribute to the formation of a nightmare script, which is then thought to be replayed over and over and to generate the nightmare distress. […] Several models have been developed to explain the pathophysiology of nightmare disorder. These include a neurocognitive model by Levin and Nielsen, which proposes that nightmares reflect disturbed emotion regulation and involve the amygdala, medial, prefrontal cortex, hippocampus, and anterior cingulate cortex. […] The pathogenesis of sleep paralysis may involve variations in circadian rhythm genes. […] Predisposing factors include sleep deprivation, irregular sleepwake schedules, and jetlag.

• #20 Nightmare Disorder and Isolated Sleep Paralysis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8116464/

  Several models have been developed to explain the pathophysiology of nightmare disorder. These include a neurocognitive model by Levin and Nielsen, which proposes that nightmares reflect disturbed emotion regulation and involve the amygdala, medial, prefrontal cortex, hippocampus, and anterior cingulate cortex.

• #21 Nightmare Disorder in Adults

  https://www.mindyra.com/solutions/adults/nightmare

  Nightmare disorder is a psychiatric disorder that affects approximately 2 -5% of adults. […] Little is known about the neurobiology of nightmare disorder. However, some studies have linked nightmares to various neurotransmitter systems, in particular norepinephrine, serotonin, and dopamine, and to activity in affective neural networks, including the amygdala, hippocampus, medial prefrontal cortex, and anterior cingulate cortex. […] It is not clear if different types of nightmares (e.g., those associated with nightmare disorder versus substance use or withdrawal) share a common underlying pathophysiology. Individuals with nightmare disorder are more likely to endorse a history of adverse events, which may contribute to the incidence of nightmares.

• #22

  https://link.springer.com/article/10.1134/S1819712419030127

  It is hypothesized that the basis of nightmares in post-traumatic stress disorder (PTSD) is modification of synaptic transmission in neural circuits that contain one of the following structures: the visual cortex, prefrontal cortex (PfC), basolateral amygdala (BLA), hippocampus, connected with them nuclei of the thalamus and basal ganglia (BG). […] The emergence of dreams is promoted by the induction of long-term potentiation of excitatory inputs to the striatonigral cells and the long-term depression of the inputs to the striatopallidal cells that are connected with the visual cortex, and give rise, respectively, to a direct and indirect path way through the BG. […] The occurrence of emotionally negative episodes in dreams is a consequence of an increase in BLA activity during PTSD, whose signals are summed with the signals from the hippocampus and PfC on the neurons of the ventral striatum.

• #23

  https://link.springer.com/article/10.1134/S1819712419030127

  It is hypothesized that the basis of nightmares in post-traumatic stress disorder (PTSD) is modification of synaptic transmission in neural circuits that contain one of the following structures: the visual cortex, prefrontal cortex (PfC), basolateral amygdala (BLA), hippocampus, connected with them nuclei of the thalamus and basal ganglia (BG). […] The emergence of dreams is promoted by the induction of long-term potentiation of excitatory inputs to the striatonigral cells and the long-term depression of the inputs to the striatopallidal cells that are connected with the visual cortex, and give rise, respectively, to a direct and indirect path way through the BG. […] The occurrence of emotionally negative episodes in dreams is a consequence of an increase in BLA activity during PTSD, whose signals are summed with the signals from the hippocampus and PfC on the neurons of the ventral striatum.

• #24 The Physiology of Nightmares

  https://www.neurologylive.com/view/physiology-nightmares

  Now research reveals the presence of physiological changes in research participants while suffering from bad dreams. […] Beyond the psychological issues, there is the question of whether there are systemic, biological changes associated with nightmares. New research reveals the presence of physiological changes in the hypothalamic hypophyseal axis among research participants who report suffering from bad dreams. […] Interestingly, a small sample study demonstrated that women who reported nightmares were found to have a blunted cortisol awakening response on working days. […] It is interesting, therefore, that an inherent deficit of stimulatory hormone levels had been associated with nightmares in more than one scientific research study. Physiologic hypostimulation then, may be an emerging area of study in the etiology of nightmares. […] However, the association between nightmares and physiologic changes is a fairly new finding. This is an important consideration in terms of the possibility of sustained neuroendocrine dysfunction as a result of nightmares.

• #25 The Physiology of Nightmares

  https://www.neurologylive.com/view/physiology-nightmares

  Now research reveals the presence of physiological changes in research participants while suffering from bad dreams. […] Beyond the psychological issues, there is the question of whether there are systemic, biological changes associated with nightmares. New research reveals the presence of physiological changes in the hypothalamic hypophyseal axis among research participants who report suffering from bad dreams. […] Interestingly, a small sample study demonstrated that women who reported nightmares were found to have a blunted cortisol awakening response on working days. […] It is interesting, therefore, that an inherent deficit of stimulatory hormone levels had been associated with nightmares in more than one scientific research study. Physiologic hypostimulation then, may be an emerging area of study in the etiology of nightmares. […] However, the association between nightmares and physiologic changes is a fairly new finding. This is an important consideration in terms of the possibility of sustained neuroendocrine dysfunction as a result of nightmares.

• #26 Nightmares | MedLink Neurology

  https://www.medlink.com/articles/nightmares

  Findings of a sleep-lab study on participants with frequent nightmares indicate that they had increased high-frequency spectral power during NREM and pre-REM periods, as well as relatively reduced slow frequency and increased fast frequency spectral power across pre- and post-REM periods as compared with healthy controls. […] This combination of reduced sleep-protective activity and increased hyperarousal suggests an imbalance between sleep regulatory and wake-promoting systems in participants with frequent nightmares. […] Findings of another study do not support the concept that abnormal REM sleep plays a role in the pathophysiology of frequent nightmares; rather, the altered REM sleep in nightmare disorder could have been confounded with comorbid pathologies. […] Furthermore, it is suggested that there is altered autonomic activity (parasympathetic) during sleep among nightmare recallers. […] A study has shown a significant difference in heart rate of nightmare recallers compared to healthy control subjects that occurs only during the sleep and not during restful wakefulness.

• #27 Nightmares share strong genetic risk with sleep and psychiatric disorders | bioRxiv

  https://www.biorxiv.org/content/10.1101/836452v1.full-text

  Nightmares are vivid, extended and extremely dysphoric dreams that awaken the dreamer. Twin studies indicate that nightmare frequency has a heritability between 36 and 51% providing evidence for genetic factors underlying predisposition to nightmares. […] To examine the biological mechanisms behind nightmares, we performed a genome-wide association study in 28,596 individuals from Finland and the United States. We identified individual genetic variants that predispose to nightmares near MYOF (rs701873, p=2.18e-8) and PTPRJ (rs11039471,p=3.7e-8), a gene previously associated with sleep duration. […] Our findings suggest that nightmares are caused by unique genetic risk factors, and here we identify the first individual genetic associations. In addition, a substantial effect on nightmares is conveyed through underlying psychological and sleep problems, with psychological problems being causal for nightmares.

• #28 Nightmares and nightmare disorder in adults – UpToDate

  https://www.uptodate.com/contents/nightmares-and-nightmare-disorder-in-adults/print

  Nightmares may occur with increased frequency during times of stress or emotional instability and may disturb the quality and continuity of sleep. […] In a Finnish nationwide twin cohort study, monozygotic twins had more similar rates of nightmares than dizygotic twins, suggesting a genetic propensity. […] The mechanism of effect of prazosin in nightmare disorder may relate to its ability to blunt the noradrenergic nervous system, which has been implicated in the hyperarousal state of PTSD.

• #29 Nightmares and nightmare disorder in adults – UpToDate

  https://www.uptodate.com/contents/nightmares-and-nightmare-disorder-in-adults/print

  Nightmares may occur with increased frequency during times of stress or emotional instability and may disturb the quality and continuity of sleep. […] In a Finnish nationwide twin cohort study, monozygotic twins had more similar rates of nightmares than dizygotic twins, suggesting a genetic propensity. […] The mechanism of effect of prazosin in nightmare disorder may relate to its ability to blunt the noradrenergic nervous system, which has been implicated in the hyperarousal state of PTSD.

• #30 Nightmares share strong genetic risk with sleep and psychiatric disorders | bioRxiv

  https://www.biorxiv.org/content/10.1101/836452v1.full-text

  Nightmares are vivid, extended and extremely dysphoric dreams that awaken the dreamer. Twin studies indicate that nightmare frequency has a heritability between 36 and 51% providing evidence for genetic factors underlying predisposition to nightmares. […] To examine the biological mechanisms behind nightmares, we performed a genome-wide association study in 28,596 individuals from Finland and the United States. We identified individual genetic variants that predispose to nightmares near MYOF (rs701873, p=2.18e-8) and PTPRJ (rs11039471,p=3.7e-8), a gene previously associated with sleep duration. […] Our findings suggest that nightmares are caused by unique genetic risk factors, and here we identify the first individual genetic associations. In addition, a substantial effect on nightmares is conveyed through underlying psychological and sleep problems, with psychological problems being causal for nightmares.

• #31 Nightmares share strong genetic risk with sleep and psychiatric disorders | bioRxiv

  https://www.biorxiv.org/content/10.1101/836452.full

  In this study we show that nightmares associate strongly with psychiatric and sleep traits at the genetic level. In addition, we show that psychiatric traits, notably those related to miserableness and nervous feelings can be causal for nightmares, while nightmares as such are not causal for the psychiatric traits. […] We identified a novel individual risk variant for nightmares intronic for gene encoding PTPRJ. This locus has been previously associated with sleep duration and short sleep suggesting a possible larger effect of variation at the PTPRJ locus on sleep and nightmares. PTPRJ is a pleiotropic tyrosine phosphatase, previously implicated in regulation of angiogenesis, amount of platelets, cancer, blood glucose levels but also sleep duration and axonal growth. […] Our study is unique as there are no other large samples available with phenotyping for nightmares, and is the first to examine genetic determinants of nightmares.

• #32 Nightmares share genetic risk factors with sleep and psychiatric traits | Translational Psychiatry

  https://www.nature.com/articles/s41398-023-02637-6

  Nightmares are vivid, extended, and emotionally negative or negative dreams that awaken the dreamer. […] frequent nightmares often reflect underlying pathologies of emotional regulation. […] insomnia, depression, anxiety, or alcohol use have been associated with nightmares in epidemiological and clinical studies. […] the genetic correlation analysis showed a robust correlation (rg 0.4) of nightmares with anxiety (rg = 0.671, p=7.507e06), depressive (rg = 0.562, p=1.282e07) and posttraumatic stress disorders (rg = 0.4083, p=0.0152), and personality trait neuroticism (rg = 0.667, p=4.516e07). […] Mendelian randomization suggested causality from insomnia to nightmares (beta = 0.027, p=0.0002). […] our findings suggest that nightmares share genetic background with psychiatric traits and that insomnia may increase an individual’s liability to experience frequent nightmares.

• #33 Nightmares share genetic risk factors with sleep and psychiatric traits | Translational Psychiatry

  https://www.nature.com/articles/s41398-023-02637-6

  Nightmares are vivid, extended, and emotionally negative or negative dreams that awaken the dreamer. […] frequent nightmares often reflect underlying pathologies of emotional regulation. […] insomnia, depression, anxiety, or alcohol use have been associated with nightmares in epidemiological and clinical studies. […] the genetic correlation analysis showed a robust correlation (rg 0.4) of nightmares with anxiety (rg = 0.671, p=7.507e06), depressive (rg = 0.562, p=1.282e07) and posttraumatic stress disorders (rg = 0.4083, p=0.0152), and personality trait neuroticism (rg = 0.667, p=4.516e07). […] Mendelian randomization suggested causality from insomnia to nightmares (beta = 0.027, p=0.0002). […] our findings suggest that nightmares share genetic background with psychiatric traits and that insomnia may increase an individual’s liability to experience frequent nightmares.

• #34 Nightmare Disorder in Adults

  https://www.mindyra.com/solutions/adults/nightmare

  Nightmare disorder is a psychiatric disorder that affects approximately 2 -5% of adults. […] Little is known about the neurobiology of nightmare disorder. However, some studies have linked nightmares to various neurotransmitter systems, in particular norepinephrine, serotonin, and dopamine, and to activity in affective neural networks, including the amygdala, hippocampus, medial prefrontal cortex, and anterior cingulate cortex. […] It is not clear if different types of nightmares (e.g., those associated with nightmare disorder versus substance use or withdrawal) share a common underlying pathophysiology. Individuals with nightmare disorder are more likely to endorse a history of adverse events, which may contribute to the incidence of nightmares.

• #35 Nightmares and nightmare disorder in adults – UpToDate

  https://www.uptodate.com/contents/nightmares-and-nightmare-disorder-in-adults

  There is a strong correlation between nightmares and suicide risk. Individuals with frequent nightmares are more likely to attempt suicide and self-harming behaviors, possibly mediated through emotional regulation difficulties and negative cognitive appraisals. […] The mechanism of effect of prazosin in nightmare disorder may relate to its ability to blunt the noradrenergic nervous system, which has been implicated in the hyperarousal state of PTSD. In patients with PTSD, there is evidence for increased sensitization of the noradrenergic nervous system and elevated levels of norepinephrine in the cerebrospinal fluid.

• #36 Management of nightmares in patients with posttraumatic stress disorde | NSS

  https://www.dovepress.com/management-of-nightmares-in-patients-with-posttraumatic-stress-disorde-peer-reviewed-fulltext-article-NSS

  The use of -1 adrenergic receptor antagonists in the treatment of PTSD-associated nightmares is predicated on the fact that consolidation of emotional memories is facilitated by the activation of -1 adrenergic receptors. […] Prazosin has emerged as the leading agent for the treatment of PTSD-related nightmares because of its putative role in disrupting consolidation of fear memories and reducing primitive fear response. […] A meta-analysis of six RCTs comparing prazosin to placebo found a significant reduction in nightmares distress and/or frequency as well as overall PTSD symptoms. […] The average daily dose ranged between 8 and 20 mg/day. […] The most significant adverse reaction to prazosin is the first dose phenomenon characterized by precipitous drop in blood pressure and sudden loss of consciousness when given at 2 mg or greater.

• #37 6 Medications That Can Cause Night Terrors in Adults – BuzzRx

  https://www.buzzrx.com/blog/6-medications-that-can-cause-night-terrors-in-adults

  Various factors can trigger the occurrence of night terrors, including certain medications. Night terrors are common in children but can also affect adults. […] We will also learn the mechanisms and factors associated with causing nightmares. […] The mechanism by which SSRIs cause sleep terrors and nightmares is incredibly complex and has yet to be fully understood. More research is essential to learn about the relationship between SSRIs and sleep side effects. […] The mechanism behind this is that they can affect neurotransmitter levels in the brain, such as serotonin and norepinephrine. […] It is important to understand why and how medications can trigger night terrors. Some of the reasons are: […] Certain medications are designed to target neurotransmitter levels in the brain to treat certain health conditions. However, due to the complexity of these brain chemicals, imbalance of certain brain chemicals and hormones can lead to nightmares or sleep terrors.

• #38 Nightmare Disorder in Adults

  https://www.mindyra.com/solutions/adults/nightmare

  Nightmare disorder is a psychiatric disorder that affects approximately 2 -5% of adults. […] Little is known about the neurobiology of nightmare disorder. However, some studies have linked nightmares to various neurotransmitter systems, in particular norepinephrine, serotonin, and dopamine, and to activity in affective neural networks, including the amygdala, hippocampus, medial prefrontal cortex, and anterior cingulate cortex. […] It is not clear if different types of nightmares (e.g., those associated with nightmare disorder versus substance use or withdrawal) share a common underlying pathophysiology. Individuals with nightmare disorder are more likely to endorse a history of adverse events, which may contribute to the incidence of nightmares.

• #39 Nightmare disorder – Wikipedia

  https://en.wikipedia.org/wiki/Nightmare_disorder

  The nightmares may be idiopathic or could be associated with psychiatric disorders like post-traumatic stress disorder, schizophrenia, and borderline personality disorder. Nightmares can also be triggered by stress and anxiety and substance abuse, such as drugs that affect the neurotransmitters norepinephrine and dopamine and serotonin. Nevertheless, causality between drugs such as beta-blockers or alpha-agonists and nightmares is still unclear and further research needs to be done to investigate the biochemical mechanisms of nightmares. […] Eighty percent of patients who have PTSD report nightmares. Patients with PTSD have symptoms that are classified into three clusters: intrusive/re-experiencing, numbing, and hyperarousal. Nightmares are usually considered to be part of the intrusive/re-experiencing symptom.

• #40 Nightmare Disorder in Adults

  https://www.mindyra.com/solutions/adults/nightmare

  Nightmare disorder is a psychiatric disorder that affects approximately 2 -5% of adults. […] Little is known about the neurobiology of nightmare disorder. However, some studies have linked nightmares to various neurotransmitter systems, in particular norepinephrine, serotonin, and dopamine, and to activity in affective neural networks, including the amygdala, hippocampus, medial prefrontal cortex, and anterior cingulate cortex. […] It is not clear if different types of nightmares (e.g., those associated with nightmare disorder versus substance use or withdrawal) share a common underlying pathophysiology. Individuals with nightmare disorder are more likely to endorse a history of adverse events, which may contribute to the incidence of nightmares.

• #41 Nightmares and nightmare disorder in adults – UpToDate

  https://www.uptodate.com/contents/nightmares-and-nightmare-disorder-in-adults/print

  Trauma—Patients with a history of physical or emotional trauma are at increased risk for nightmares and related symptoms of intrusion, negative mood, dissociation, avoidance, and arousal. […] PTSD can occur after many types of trauma, including sexual assault, mass conflict and displacement, combat, and severe medical illnesses or injuries. […] There is a strong correlation between nightmares and suicide risk. […] In patients with depression, alterations in sleep architecture, including shortened REM latencies and increased density of REM sleep, may contribute to the increased rate of dysphoric dreams and nightmares. […] A wide range of medications have been implicated in generating nightmares. […] Nightmares commonly occur during withdrawal from GABA-ergic medications or substances such as alcohol, barbiturates, and benzodiazepines.

• #42

  https://link.springer.com/article/10.1134/S1819712419030127

  This mechanism suggests that, in order to prevent nightmares, it is necessary to induce long-term depression of the excitatory inputs to the neurons of the limbic structures and to the striatonigral cells. […] Given the data on the types of receptors on striatal neurons, it follows from the modulation rules we earlier formulated that nightmares may be prevented by antagonists of dopamine D1 receptor and alpha1 adrenoceptor and agonists of glucocorticoid, serotonin 5-HT1B, and cannabinoid CB1 receptors. […] The use of mineralocorticoid and serotonin 5-HT2A receptor agonists, as well as antagonists of alpha2 adrenoreceptors and dopamine D2 receptors (which are part of some antidepressants and antipsychotics) is undesirable in order to avoid side effects.

• #43 The Possible Mechanism of the Appearance of Nightmares in Post-Traumatic Stress Disorder and Approaches to Their Prevention – Silkis – Neurochemical Journal

  https://journals.rcsi.science/1819-7124/article/view/211777

  This mechanism suggests that, in order to prevent nightmares, it is necessary to induce long-term depression of the excitatory inputs to the neurons of the limbic structures and to the striatonigral cells. […] Given the data on the types of receptors on striatal neurons, it follows from the modulation rules we earlier formulated that nightmares may be prevented by antagonists of dopamine D1 receptor and alpha1 adrenoceptor and agonists of glucocorticoid, serotonin 5-HT1B, and cannabinoid CB1 receptors. […] The treatment should be short-term and used only at bedtime, to avoid impairments of physical activity and sensory perception in the awake state.

• #44 Management of nightmares in patients with posttraumatic stress disorde | NSS

  https://www.dovepress.com/management-of-nightmares-in-patients-with-posttraumatic-stress-disorde-peer-reviewed-fulltext-article-NSS

  Nightmares are considered the hallmark of posttraumatic stress disorder (PTSD). […] the pathophysiology exposes central dysfunction of brain structures at the level of the hippocampus, amygdala, and locus coeruleus, modulated by neurochemical imbalance in noradrenergic, dopaminergic, and serotonin pathways. […] The exact relation between nightmares and PTSD is still unknown but nightmares and PTSD are closely related, and both show altered activity in the same brain regions. […] Among the factors implicated in the importunity of nightmares after trauma are persistence thoughts of helplessness and lack of control, fear and hyperarousal, and REM disruption. […] Chronic nightmares in PTSD are associated with adverse consequences and decreased psychological and physiological functioning as well as disturbed sleep.

• #45 Nightmare Disorder and Effect on the Brain – DRAFT ONLY Cognitive Neuroscience

  https://caul-cbua.pressbooks.pub/cogneuro/chapter/nightmare-disorder-and-effect-on-the-brain/

  The aetiology of nightmare disorder is still being researched, the leading theories suggest hyperarousal and impaired fear extinction are what causes the disorder. […] Hyperarousal is also a primary pathophysiological factor in other disorders, such as PTSD and insomnia. […] Healthy sleepers with normally functioning fear extinction are able to recombine negative memories with novel and dissociated contexts. […] People with high afferent load and afferent distress are more likely to have impaired fear extinction, and people with impaired fear extinction are more likely to have nightmares that constitute a clinical problem such as nightmare disorder. […] This suggests that the hyperarousal experienced by people with nightmare disorder, as well as PTSD, is linked to the high activation of the inferior parietal lobule.

• #46 Nightmare disorder – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/nightmare-disorder/symptoms-causes/syc-20353515

  Nightmare disorder is referred to by doctors as a parasomnia a type of sleep disorder that involves undesirable experiences that occur while you’re falling asleep, during sleep or when you’re waking up. Nightmares usually occur during the stage of sleep known as rapid eye movement (REM) sleep. The exact cause of nightmares is not known. […] Nightmares can be triggered by many factors, including: […] Stress or anxiety. Sometimes the ordinary stresses of daily life, such as a problem at home or school, trigger nightmares. A major change, such as a move or the death of a loved one, can have the same effect. Experiencing anxiety is associated with a greater risk of nightmares. […] Trauma. Nightmares are common after an accident, injury, physical or sexual abuse, or other traumatic event. Nightmares are common in people who have post-traumatic stress disorder (PTSD).

• #47 Nightmare Disorder Clinical Presentation: History, Physical, Causes

  https://emedicine.medscape.com/article/914428-clinical

  Developmental, genetic, psychological, and organic factors can contribute to occurrence. A high prevalence of parasomnias in early childhood has been associated with separation anxiety. […] Multiple studies have demonstrated that a child’s general level of anxiety is related to nightmare severity and frequency. […] Nightmares are more common in children with intellectual disability, depression, and CNS diseases; an association has also been reported with febrile illnesses. […] Medications may induce frightening dreams, either during treatment or following withdrawal. Withdrawal of medications that suppress REM sleep, including tricyclic antidepressants and selective serotonin reuptake inhibitors, can lead to an REM rebound effect that is accompanied by nightmares. […] Nightmares are associated with anxiety disorders, particularly in adolescents.

• #48 Nightmare disorder – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/nightmare-disorder/symptoms-causes/syc-20353515

  Nightmare disorder is referred to by doctors as a parasomnia a type of sleep disorder that involves undesirable experiences that occur while you’re falling asleep, during sleep or when you’re waking up. Nightmares usually occur during the stage of sleep known as rapid eye movement (REM) sleep. The exact cause of nightmares is not known. […] Nightmares can be triggered by many factors, including: […] Stress or anxiety. Sometimes the ordinary stresses of daily life, such as a problem at home or school, trigger nightmares. A major change, such as a move or the death of a loved one, can have the same effect. Experiencing anxiety is associated with a greater risk of nightmares. […] Trauma. Nightmares are common after an accident, injury, physical or sexual abuse, or other traumatic event. Nightmares are common in people who have post-traumatic stress disorder (PTSD).

• #49 Nightmare disorder – Wikipedia

  https://en.wikipedia.org/wiki/Nightmare_disorder

  The nightmares may be idiopathic or could be associated with psychiatric disorders like post-traumatic stress disorder, schizophrenia, and borderline personality disorder. Nightmares can also be triggered by stress and anxiety and substance abuse, such as drugs that affect the neurotransmitters norepinephrine and dopamine and serotonin. Nevertheless, causality between drugs such as beta-blockers or alpha-agonists and nightmares is still unclear and further research needs to be done to investigate the biochemical mechanisms of nightmares. […] Eighty percent of patients who have PTSD report nightmares. Patients with PTSD have symptoms that are classified into three clusters: intrusive/re-experiencing, numbing, and hyperarousal. Nightmares are usually considered to be part of the intrusive/re-experiencing symptom.

• #50 Management of nightmares in patients with posttraumatic stress disorde | NSS

  https://www.dovepress.com/management-of-nightmares-in-patients-with-posttraumatic-stress-disorde-peer-reviewed-fulltext-article-NSS

  Nightmares are considered the hallmark of posttraumatic stress disorder (PTSD). […] the pathophysiology exposes central dysfunction of brain structures at the level of the hippocampus, amygdala, and locus coeruleus, modulated by neurochemical imbalance in noradrenergic, dopaminergic, and serotonin pathways. […] The exact relation between nightmares and PTSD is still unknown but nightmares and PTSD are closely related, and both show altered activity in the same brain regions. […] Among the factors implicated in the importunity of nightmares after trauma are persistence thoughts of helplessness and lack of control, fear and hyperarousal, and REM disruption. […] Chronic nightmares in PTSD are associated with adverse consequences and decreased psychological and physiological functioning as well as disturbed sleep.

• #51 Nightmare disorder – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/nightmare-disorder/symptoms-causes/syc-20353515

  Nightmare disorder is referred to by doctors as a parasomnia a type of sleep disorder that involves undesirable experiences that occur while you’re falling asleep, during sleep or when you’re waking up. Nightmares usually occur during the stage of sleep known as rapid eye movement (REM) sleep. The exact cause of nightmares is not known. […] Nightmares can be triggered by many factors, including: […] Stress or anxiety. Sometimes the ordinary stresses of daily life, such as a problem at home or school, trigger nightmares. A major change, such as a move or the death of a loved one, can have the same effect. Experiencing anxiety is associated with a greater risk of nightmares. […] Trauma. Nightmares are common after an accident, injury, physical or sexual abuse, or other traumatic event. Nightmares are common in people who have post-traumatic stress disorder (PTSD).

• #52 Nightmares | MedLink Neurology

  https://www.medlink.com/articles/nightmares

  Genetic and environmental factors are involved in the pathogenesis of nightmares. […] There is a strong relationship between nightmare frequency and psychiatric disorders. […] Nightmares as symptoms of PTSD are critical because sleep disruption may lead to maintenance of PTSD in a vicious circle. […] Nightmares may occur as side effects of medications. […] Various studies suggest that some genetic factors, in addition to unrelated environmental effects, are involved in the pathogenesis of nightmares. […] Pathophysiology of nightmares is not clear but several hypotheses to account for nightmares have been proposed in the past. […] According to the stress acceleration hypothesis, adverse childhood experiences have a deleterious impact on future physical and mental health, increasing risk for psychiatric problems, sleep disorders, and idiopathic nightmares.

• #53 Nightmare disorder – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/nightmare-disorder/symptoms-causes/syc-20353515

  Sleep deprivation. Changes in your schedule that cause irregular sleeping and waking times or that interrupt or reduce the amount of sleep you get can increase your risk of having nightmares. Insomnia is associated with an increased risk of nightmares. […] Medications. Some drugs including certain antidepressants, blood pressure medications, beta blockers, and drugs used to treat Parkinson’s disease or to help stop smoking can trigger nightmares. […] Substance misuse. Alcohol and recreational drug use or withdrawal can trigger nightmares. […] Other disorders. Depression and other mental health disorders may be linked to nightmares. Nightmares can happen along with some medical conditions, such as heart disease or cancer. Having other sleep disorders that interfere with adequate sleep can be associated with having nightmares. […] Scary books and movies. For some people, reading scary books or watching frightening movies, especially before bed, can be associated with nightmares.

• #54 What Causes Nightmares?

  https://sleepdoctor.com/pages/health/nightmares

  Several sleep disorders are associated with an increased risk of nightmares, including insomnia, obstructive sleep apnea, sleep related movement disorders, and narcolepsy. […] When recurrent nightmares interfere with a person’s ability to function during the day, they may be diagnosed as nightmare disorder. Nightmare disorder is a type of sleep disorder called a parasomnia. […] Understanding the cause of nightmares is an important step to reducing their frequency.

• #55 Nightmare disorder – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/nightmare-disorder/symptoms-causes/syc-20353515

  Sleep deprivation. Changes in your schedule that cause irregular sleeping and waking times or that interrupt or reduce the amount of sleep you get can increase your risk of having nightmares. Insomnia is associated with an increased risk of nightmares. […] Medications. Some drugs including certain antidepressants, blood pressure medications, beta blockers, and drugs used to treat Parkinson’s disease or to help stop smoking can trigger nightmares. […] Substance misuse. Alcohol and recreational drug use or withdrawal can trigger nightmares. […] Other disorders. Depression and other mental health disorders may be linked to nightmares. Nightmares can happen along with some medical conditions, such as heart disease or cancer. Having other sleep disorders that interfere with adequate sleep can be associated with having nightmares. […] Scary books and movies. For some people, reading scary books or watching frightening movies, especially before bed, can be associated with nightmares.

• #56 Aetiology and treatment of nightmare disorder: State of the art and future perspectives

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6850667/

  Several factors have been proposed as facilitating hyperarousal and impaired fear extinction in patients diagnosed with nightmare disorder. […] According to the AND model, fear extinction capacity is impaired by the consequences of traumatic experiences, although developmental stress such as early childhood adversity may initiate some similar mechanisms. […] The theory of differential susceptibility is consistent with the developmental tenets of the AND and SAH models, which suppose that traumatic experiences and early childhood adversity augment trait sensitivity in susceptible individuals. […] Maladaptive beliefs may play a role in the aetiology of nightmare disorder. […] One physiological factor that may explain some aspects of hyperarousal in nightmare patients and which may impede fear extinction is the severe sleep fragmentation caused by obstructive and central sleep apnea. […] All the above factors may contribute to the condensing of recurrent nightmare elements into a nightmare script.

• #57 Nightmare disorder – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/nightmare-disorder/symptoms-causes/syc-20353515

  Sleep deprivation. Changes in your schedule that cause irregular sleeping and waking times or that interrupt or reduce the amount of sleep you get can increase your risk of having nightmares. Insomnia is associated with an increased risk of nightmares. […] Medications. Some drugs including certain antidepressants, blood pressure medications, beta blockers, and drugs used to treat Parkinson’s disease or to help stop smoking can trigger nightmares. […] Substance misuse. Alcohol and recreational drug use or withdrawal can trigger nightmares. […] Other disorders. Depression and other mental health disorders may be linked to nightmares. Nightmares can happen along with some medical conditions, such as heart disease or cancer. Having other sleep disorders that interfere with adequate sleep can be associated with having nightmares. […] Scary books and movies. For some people, reading scary books or watching frightening movies, especially before bed, can be associated with nightmares.

• #58 Nightmare Disorder Clinical Presentation: History, Physical, Causes

  https://emedicine.medscape.com/article/914428-clinical

  Daytime emotional conflicts and psychological stress often contaminate sleep and predispose the child to nightmares. […] Nightmares may result from a severe traumatic event and may indicate posttraumatic stress disorder. […] In a Finnish adult population, depression and insomnia were the strongest risk factors for nightmare frequency. […] Nightmares may be more frequent during pregnancy.

• #59 Nightmare Disorder Clinical Presentation: History, Physical, Causes

  https://emedicine.medscape.com/article/914428-clinical

  Developmental, genetic, psychological, and organic factors can contribute to occurrence. A high prevalence of parasomnias in early childhood has been associated with separation anxiety. […] Multiple studies have demonstrated that a child’s general level of anxiety is related to nightmare severity and frequency. […] Nightmares are more common in children with intellectual disability, depression, and CNS diseases; an association has also been reported with febrile illnesses. […] Medications may induce frightening dreams, either during treatment or following withdrawal. Withdrawal of medications that suppress REM sleep, including tricyclic antidepressants and selective serotonin reuptake inhibitors, can lead to an REM rebound effect that is accompanied by nightmares. […] Nightmares are associated with anxiety disorders, particularly in adolescents.

• #60 Nightmare Disorder: Symptoms, Causes, Treatment

  https://www.verywellmind.com/nightmare-disorder-definition-symptoms-causes-treatment-5220095

  Researchers also found that those with a history of nightmares reported having greater PTSD symptoms than those without. […] Additionally, nightmares related to a traumatic event are associated with more severe PTSD symptoms. PTSD can also predispose an individual to other psychological conditions, like anxiety or depression, and these neurological or mental symptoms can increase the likelihood of having nightmares. […] Anxiety and depressive symptoms are associated with the experience of constant nightmares, especially anxiety. […] Research has found that the prevalence of nightmare disorder is high in nurses due to anxiety, depression, and stress. […] Researchers are beginning to believe that nightmares increase ones risk of suicidality and suicidal behavior across the lifespan. […] A study examining the association between borderline personality disorder (BPD) and nightmares, found nightmares, as well as dream anxiety, and negative quality of sleep, to be more prevalent in those with BPD, than in those without.

• #61 Nightmare Disorder: Symptoms, Causes, Treatment

  https://www.verywellmind.com/nightmare-disorder-definition-symptoms-causes-treatment-5220095

  Both adults and children who have experienced early trauma have a history of altered sleep quality and nightmares. […] Dissociative disorders, which are mental disorders in which an individual experience disconnects from reality, thoughts, feelings, and identity, is also associated with nightmare disorder. […] A study found that 57% of participants with a dissociative disorder also had nightmare disorder, and those with nightmares presented greater dissociative symptoms. […] Nightmare disorder has a great impact on sleep quality, mood, and energy levels. […] The panic, anxiety, and depression associated with nightmares are also very impactful on ones quality of life. […] Treatment for nightmare disorder could be both pharmacological and/or psychotherapeutic interventions. […] After various clinical trials throughout the years examining the effectiveness of different medications on the reduction of nightmares, only prazosin exemplifies the most effective results. […] Prazosin is an FDA-approved medication for high blood pressure but has been shown to treat nightmares associated with PTSD.

• #62 Nightmare disorder – Wikipedia

  https://en.wikipedia.org/wiki/Nightmare_disorder

  The nightmares may be idiopathic or could be associated with psychiatric disorders like post-traumatic stress disorder, schizophrenia, and borderline personality disorder. Nightmares can also be triggered by stress and anxiety and substance abuse, such as drugs that affect the neurotransmitters norepinephrine and dopamine and serotonin. Nevertheless, causality between drugs such as beta-blockers or alpha-agonists and nightmares is still unclear and further research needs to be done to investigate the biochemical mechanisms of nightmares. […] Eighty percent of patients who have PTSD report nightmares. Patients with PTSD have symptoms that are classified into three clusters: intrusive/re-experiencing, numbing, and hyperarousal. Nightmares are usually considered to be part of the intrusive/re-experiencing symptom.

• #63 Nightmare disorder – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/nightmare-disorder/symptoms-causes/syc-20353515

  Sleep deprivation. Changes in your schedule that cause irregular sleeping and waking times or that interrupt or reduce the amount of sleep you get can increase your risk of having nightmares. Insomnia is associated with an increased risk of nightmares. […] Medications. Some drugs including certain antidepressants, blood pressure medications, beta blockers, and drugs used to treat Parkinson’s disease or to help stop smoking can trigger nightmares. […] Substance misuse. Alcohol and recreational drug use or withdrawal can trigger nightmares. […] Other disorders. Depression and other mental health disorders may be linked to nightmares. Nightmares can happen along with some medical conditions, such as heart disease or cancer. Having other sleep disorders that interfere with adequate sleep can be associated with having nightmares. […] Scary books and movies. For some people, reading scary books or watching frightening movies, especially before bed, can be associated with nightmares.

• #64 Nightmares and nightmare disorder in adults – UpToDate

  https://www.uptodate.com/contents/nightmares-and-nightmare-disorder-in-adults

  There is a strong correlation between nightmares and suicide risk. Individuals with frequent nightmares are more likely to attempt suicide and self-harming behaviors, possibly mediated through emotional regulation difficulties and negative cognitive appraisals. […] The mechanism of effect of prazosin in nightmare disorder may relate to its ability to blunt the noradrenergic nervous system, which has been implicated in the hyperarousal state of PTSD. In patients with PTSD, there is evidence for increased sensitization of the noradrenergic nervous system and elevated levels of norepinephrine in the cerebrospinal fluid.

• #65 Management of nightmares in patients with posttraumatic stress disorde | NSS

  https://www.dovepress.com/management-of-nightmares-in-patients-with-posttraumatic-stress-disorde-peer-reviewed-fulltext-article-NSS

  PTSD and nightmares are intertwined in such a manner that nightmares strengthen PTSD symptoms, and PTSD in turn causes nightmares. […] However, the presence of nightmares not only influences the development of PTSD but also accelerates the progression of PTSD following trauma exposure. […] The distressing nature of these nightmares occasionally results in the display of avoidance behavior before bedtime such as staying late or leaving the lights on at night, which ultimately lead to insomnia and daytime dysfunction. […] One study had linked nightmares to a fivefold increase in suicidality. […] The mechanism by which nightmares confer suicidality has not been identified; however, the common denominator linking these entities together has been ascribed to the sense of entrapment, defeat, and hopelessness.

• #66 Nightmare disorder – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/nightmare-disorder/symptoms-causes/syc-20353515

  Sleep deprivation. Changes in your schedule that cause irregular sleeping and waking times or that interrupt or reduce the amount of sleep you get can increase your risk of having nightmares. Insomnia is associated with an increased risk of nightmares. […] Medications. Some drugs including certain antidepressants, blood pressure medications, beta blockers, and drugs used to treat Parkinson’s disease or to help stop smoking can trigger nightmares. […] Substance misuse. Alcohol and recreational drug use or withdrawal can trigger nightmares. […] Other disorders. Depression and other mental health disorders may be linked to nightmares. Nightmares can happen along with some medical conditions, such as heart disease or cancer. Having other sleep disorders that interfere with adequate sleep can be associated with having nightmares. […] Scary books and movies. For some people, reading scary books or watching frightening movies, especially before bed, can be associated with nightmares.

• #67 Nightmares and nightmare disorder in adults – UpToDate

  https://www.uptodate.com/contents/nightmares-and-nightmare-disorder-in-adults

  Nightmares are common beginning early in childhood and extending throughout the lifespan. The condition is strongly associated with stress, anxiety, and trauma. […] While nightmares are not by definition pathologic, those that are frequent or disabling and impair social, occupational, emotional, and physical wellbeing are considered a disorder and are often a sign of underlying and treatable psychopathology. Common causes include stress, negative life events, the experience of trauma as in posttraumatic stress disorder (PTSD), depression, other psychiatric disorders, and medication side effects. […] Nightmares are more prevalent during periods of stress. They can emerge in association with traumatic experiences, as in posttraumatic stress disorder (PTSD), and in association with other psychiatric diagnoses, including depression, dissociative disorders, and borderline personality disorder. Medications most commonly associated with nightmares include those that affect norepinephrine, serotonin, dopamine, acetylcholine, or gamma-aminobutyric acid (GABA) signaling.

• #68 Nightmare disorder – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/nightmare-disorder/symptoms-causes/syc-20353515

  Sleep deprivation. Changes in your schedule that cause irregular sleeping and waking times or that interrupt or reduce the amount of sleep you get can increase your risk of having nightmares. Insomnia is associated with an increased risk of nightmares. […] Medications. Some drugs including certain antidepressants, blood pressure medications, beta blockers, and drugs used to treat Parkinson’s disease or to help stop smoking can trigger nightmares. […] Substance misuse. Alcohol and recreational drug use or withdrawal can trigger nightmares. […] Other disorders. Depression and other mental health disorders may be linked to nightmares. Nightmares can happen along with some medical conditions, such as heart disease or cancer. Having other sleep disorders that interfere with adequate sleep can be associated with having nightmares. […] Scary books and movies. For some people, reading scary books or watching frightening movies, especially before bed, can be associated with nightmares.

• #69 Nightmare disorder – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/nightmare-disorder/symptoms-causes/syc-20353515

  Sleep deprivation. Changes in your schedule that cause irregular sleeping and waking times or that interrupt or reduce the amount of sleep you get can increase your risk of having nightmares. Insomnia is associated with an increased risk of nightmares. […] Medications. Some drugs including certain antidepressants, blood pressure medications, beta blockers, and drugs used to treat Parkinson’s disease or to help stop smoking can trigger nightmares. […] Substance misuse. Alcohol and recreational drug use or withdrawal can trigger nightmares. […] Other disorders. Depression and other mental health disorders may be linked to nightmares. Nightmares can happen along with some medical conditions, such as heart disease or cancer. Having other sleep disorders that interfere with adequate sleep can be associated with having nightmares. […] Scary books and movies. For some people, reading scary books or watching frightening movies, especially before bed, can be associated with nightmares.

• #70 Nightmare disorder – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/nightmare-disorder/symptoms-causes/syc-20353515

  Sleep deprivation. Changes in your schedule that cause irregular sleeping and waking times or that interrupt or reduce the amount of sleep you get can increase your risk of having nightmares. Insomnia is associated with an increased risk of nightmares. […] Medications. Some drugs including certain antidepressants, blood pressure medications, beta blockers, and drugs used to treat Parkinson’s disease or to help stop smoking can trigger nightmares. […] Substance misuse. Alcohol and recreational drug use or withdrawal can trigger nightmares. […] Other disorders. Depression and other mental health disorders may be linked to nightmares. Nightmares can happen along with some medical conditions, such as heart disease or cancer. Having other sleep disorders that interfere with adequate sleep can be associated with having nightmares. […] Scary books and movies. For some people, reading scary books or watching frightening movies, especially before bed, can be associated with nightmares.

• #71 Nightmare disorder – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/nightmare-disorder/symptoms-causes/syc-20353515

  Sleep deprivation. Changes in your schedule that cause irregular sleeping and waking times or that interrupt or reduce the amount of sleep you get can increase your risk of having nightmares. Insomnia is associated with an increased risk of nightmares. […] Medications. Some drugs including certain antidepressants, blood pressure medications, beta blockers, and drugs used to treat Parkinson’s disease or to help stop smoking can trigger nightmares. […] Substance misuse. Alcohol and recreational drug use or withdrawal can trigger nightmares. […] Other disorders. Depression and other mental health disorders may be linked to nightmares. Nightmares can happen along with some medical conditions, such as heart disease or cancer. Having other sleep disorders that interfere with adequate sleep can be associated with having nightmares. […] Scary books and movies. For some people, reading scary books or watching frightening movies, especially before bed, can be associated with nightmares.

• #72 Nightmare disorder – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/nightmare-disorder/symptoms-causes/syc-20353515

  Sleep deprivation. Changes in your schedule that cause irregular sleeping and waking times or that interrupt or reduce the amount of sleep you get can increase your risk of having nightmares. Insomnia is associated with an increased risk of nightmares. […] Medications. Some drugs including certain antidepressants, blood pressure medications, beta blockers, and drugs used to treat Parkinson’s disease or to help stop smoking can trigger nightmares. […] Substance misuse. Alcohol and recreational drug use or withdrawal can trigger nightmares. […] Other disorders. Depression and other mental health disorders may be linked to nightmares. Nightmares can happen along with some medical conditions, such as heart disease or cancer. Having other sleep disorders that interfere with adequate sleep can be associated with having nightmares. […] Scary books and movies. For some people, reading scary books or watching frightening movies, especially before bed, can be associated with nightmares.

• #73 Nightmares and nightmare disorder in adults – UpToDate

  https://www.uptodate.com/contents/nightmares-and-nightmare-disorder-in-adults/print

  Trauma—Patients with a history of physical or emotional trauma are at increased risk for nightmares and related symptoms of intrusion, negative mood, dissociation, avoidance, and arousal. […] PTSD can occur after many types of trauma, including sexual assault, mass conflict and displacement, combat, and severe medical illnesses or injuries. […] There is a strong correlation between nightmares and suicide risk. […] In patients with depression, alterations in sleep architecture, including shortened REM latencies and increased density of REM sleep, may contribute to the increased rate of dysphoric dreams and nightmares. […] A wide range of medications have been implicated in generating nightmares. […] Nightmares commonly occur during withdrawal from GABA-ergic medications or substances such as alcohol, barbiturates, and benzodiazepines.

• #74 Nightmares and Disorders of Dreaming | AAFP

  https://www.aafp.org/pubs/afp/issues/2000/0401/p2037.html

  Nightmares are a defining symptom in post-traumatic stress disorder (PTSD). Nightmares related to PTSD occur after an intensely frightening or highly emotional experience. These nightmares are often associated with disturbed sleep and altered daytime behavior, which is best described as hyperarousability. […] Polysomnographic studies in these patients have shown that they have poor sleep maintenance, increased eye movement density, decreased percentage of REM sleep and an increased tendency to have REM sleep at sleep onset (REM pressure). This phenomenon is similar to that occurring in patients with narcolepsy. […] Nightmares are also associated with the use of medication, primarily those medications that affect neurotransmitter levels of the central nervous system, such as antidepressants, narcotics or barbiturates. Intense, frightening dreams may occur during the withdrawal of drugs that cause REM sleep rebound, such as ethanol, barbiturates and benzodiazepines.

• #75 Management of nightmares in patients with posttraumatic stress disorde | NSS

  https://www.dovepress.com/management-of-nightmares-in-patients-with-posttraumatic-stress-disorde-peer-reviewed-fulltext-article-NSS

  Nightmares are considered the hallmark of posttraumatic stress disorder (PTSD). […] the pathophysiology exposes central dysfunction of brain structures at the level of the hippocampus, amygdala, and locus coeruleus, modulated by neurochemical imbalance in noradrenergic, dopaminergic, and serotonin pathways. […] The exact relation between nightmares and PTSD is still unknown but nightmares and PTSD are closely related, and both show altered activity in the same brain regions. […] Among the factors implicated in the importunity of nightmares after trauma are persistence thoughts of helplessness and lack of control, fear and hyperarousal, and REM disruption. […] Chronic nightmares in PTSD are associated with adverse consequences and decreased psychological and physiological functioning as well as disturbed sleep.

• #76 Management of nightmares in patients with posttraumatic stress disorde | NSS

  https://www.dovepress.com/management-of-nightmares-in-patients-with-posttraumatic-stress-disorde-peer-reviewed-fulltext-article-NSS

  Nightmares are considered the hallmark of posttraumatic stress disorder (PTSD). […] the pathophysiology exposes central dysfunction of brain structures at the level of the hippocampus, amygdala, and locus coeruleus, modulated by neurochemical imbalance in noradrenergic, dopaminergic, and serotonin pathways. […] The exact relation between nightmares and PTSD is still unknown but nightmares and PTSD are closely related, and both show altered activity in the same brain regions. […] Among the factors implicated in the importunity of nightmares after trauma are persistence thoughts of helplessness and lack of control, fear and hyperarousal, and REM disruption. […] Chronic nightmares in PTSD are associated with adverse consequences and decreased psychological and physiological functioning as well as disturbed sleep.

• #77 Nightmare disorder – Wikipedia

  https://en.wikipedia.org/wiki/Nightmare_disorder

  Some differences exist between idiopathic and PTSD related nightmares. A person with PTSD having nightmares would wake up during the night more frequently and for a longer time than with idiopathic nightmares. Consequently, people with PTSD would have a poorer sleep quality. Furthermore, nightmares related to PTSD would be more stressful than idiopathic ones. However, further studies have to be conducted in this area to obtain more reliable results. […] Pharmacological treatments could be also efficient to treat nightmare disorder. Most of the treatments were assessed to patients with PTSD. The most efficient is an alpha-blocker, Prazosin, which reduces tone during sleep by blocking noradrenergic receptors. Prazosin would significantly decrease the number of PTSD related nightmares and would therefore improve sleep quality. However, only few studies considered the effect of Prazosin in idiopathic nightmares.

• #78 Nightmares and Disorders of Dreaming | AAFP

  https://www.aafp.org/pubs/afp/issues/2000/0401/p2037.html

  Nightmares are a defining symptom in post-traumatic stress disorder (PTSD). Nightmares related to PTSD occur after an intensely frightening or highly emotional experience. These nightmares are often associated with disturbed sleep and altered daytime behavior, which is best described as hyperarousability. […] Polysomnographic studies in these patients have shown that they have poor sleep maintenance, increased eye movement density, decreased percentage of REM sleep and an increased tendency to have REM sleep at sleep onset (REM pressure). This phenomenon is similar to that occurring in patients with narcolepsy. […] Nightmares are also associated with the use of medication, primarily those medications that affect neurotransmitter levels of the central nervous system, such as antidepressants, narcotics or barbiturates. Intense, frightening dreams may occur during the withdrawal of drugs that cause REM sleep rebound, such as ethanol, barbiturates and benzodiazepines.

• #79 Management of nightmares in patients with posttraumatic stress disorde | NSS

  https://www.dovepress.com/management-of-nightmares-in-patients-with-posttraumatic-stress-disorde-peer-reviewed-fulltext-article-NSS

  PTSD and nightmares are intertwined in such a manner that nightmares strengthen PTSD symptoms, and PTSD in turn causes nightmares. […] However, the presence of nightmares not only influences the development of PTSD but also accelerates the progression of PTSD following trauma exposure. […] The distressing nature of these nightmares occasionally results in the display of avoidance behavior before bedtime such as staying late or leaving the lights on at night, which ultimately lead to insomnia and daytime dysfunction. […] One study had linked nightmares to a fivefold increase in suicidality. […] The mechanism by which nightmares confer suicidality has not been identified; however, the common denominator linking these entities together has been ascribed to the sense of entrapment, defeat, and hopelessness.

• #80 Management of nightmares in patients with posttraumatic stress disorde | NSS

  https://www.dovepress.com/management-of-nightmares-in-patients-with-posttraumatic-stress-disorde-peer-reviewed-fulltext-article-NSS

  PTSD and nightmares are intertwined in such a manner that nightmares strengthen PTSD symptoms, and PTSD in turn causes nightmares. […] However, the presence of nightmares not only influences the development of PTSD but also accelerates the progression of PTSD following trauma exposure. […] The distressing nature of these nightmares occasionally results in the display of avoidance behavior before bedtime such as staying late or leaving the lights on at night, which ultimately lead to insomnia and daytime dysfunction. […] One study had linked nightmares to a fivefold increase in suicidality. […] The mechanism by which nightmares confer suicidality has not been identified; however, the common denominator linking these entities together has been ascribed to the sense of entrapment, defeat, and hopelessness.

• #81 Management of nightmares in patients with posttraumatic stress disorde | NSS

  https://www.dovepress.com/management-of-nightmares-in-patients-with-posttraumatic-stress-disorde-peer-reviewed-fulltext-article-NSS

  Nightmares are considered the hallmark of posttraumatic stress disorder (PTSD). […] the pathophysiology exposes central dysfunction of brain structures at the level of the hippocampus, amygdala, and locus coeruleus, modulated by neurochemical imbalance in noradrenergic, dopaminergic, and serotonin pathways. […] The exact relation between nightmares and PTSD is still unknown but nightmares and PTSD are closely related, and both show altered activity in the same brain regions. […] Among the factors implicated in the importunity of nightmares after trauma are persistence thoughts of helplessness and lack of control, fear and hyperarousal, and REM disruption. […] Chronic nightmares in PTSD are associated with adverse consequences and decreased psychological and physiological functioning as well as disturbed sleep.

• #82 Nightmares share genetic risk factors with sleep and psychiatric traits | Translational Psychiatry

  https://www.nature.com/articles/s41398-023-02637-6

  the biological basis behind nightmares and the causality between nightmares and psychiatric traits have not been thoroughly established. […] the genetic correlation demonstrated a significant change in p-values between only baseline correction and removing individuals with heavy alcohol consumption. […] insomnia has been linked to numerous psychological and physical disorders. […] the current genetic correlations are computed in nonoverlapping samples (Finnish population vs. UK Biobank) and do not have shared individuals. […] our finding of shared genetic risk between nightmares and symptoms of insomnia would support this hypothesis. […] our findings indicate the possibility that patients with psychiatric disorders may benefit if their nightmares are managed as part of the treatment strategy by using evidence-based interventions such as imagery rehearsal therapy.

• #83 Management of nightmares in patients with posttraumatic stress disorde | NSS

  https://www.dovepress.com/management-of-nightmares-in-patients-with-posttraumatic-stress-disorde-peer-reviewed-fulltext-article-NSS

  The use of -1 adrenergic receptor antagonists in the treatment of PTSD-associated nightmares is predicated on the fact that consolidation of emotional memories is facilitated by the activation of -1 adrenergic receptors. […] Prazosin has emerged as the leading agent for the treatment of PTSD-related nightmares because of its putative role in disrupting consolidation of fear memories and reducing primitive fear response. […] A meta-analysis of six RCTs comparing prazosin to placebo found a significant reduction in nightmares distress and/or frequency as well as overall PTSD symptoms. […] The average daily dose ranged between 8 and 20 mg/day. […] The most significant adverse reaction to prazosin is the first dose phenomenon characterized by precipitous drop in blood pressure and sudden loss of consciousness when given at 2 mg or greater.

• #84 Management of Nightmare Disorder in Adults

  https://www.uspharmacist.com/article/management-of-nightmare-disorder-in-adults

  The only treatment strategy with enough evidence to be recommended in the AASM’s position paper is behavioral intervention with imagery-rehearsal therapy (IRT). IRT is based on the theory that nightmares are a learned behavior and can be replaced by a less disruptive behavior that will not ultimately affect sleep or daytime functioning. […] Prazosin remains the drug of choice and is the only one indicated for both nightmare types. Therefore, prazosin will be discussed first, followed by the remaining agents and drug classes in alphabetical order. […] The 2010 AASM best-practice guide recommended prazosin for nightmare disorder; however, the current position paper has downgraded its classification to may be used based on a recent publication that did not find a statistical difference versus placebo. […] These medications, however, are limited by their adverse-effect profile. […] Despite positive results in several studies of PTSD-associated nightmares, topiramate use may be limited because of adverse effects.

• #85 Management of Nightmare Disorder in Adults

  https://www.uspharmacist.com/article/management-of-nightmare-disorder-in-adults

  The only treatment strategy with enough evidence to be recommended in the AASM’s position paper is behavioral intervention with imagery-rehearsal therapy (IRT). IRT is based on the theory that nightmares are a learned behavior and can be replaced by a less disruptive behavior that will not ultimately affect sleep or daytime functioning. […] Prazosin remains the drug of choice and is the only one indicated for both nightmare types. Therefore, prazosin will be discussed first, followed by the remaining agents and drug classes in alphabetical order. […] The 2010 AASM best-practice guide recommended prazosin for nightmare disorder; however, the current position paper has downgraded its classification to may be used based on a recent publication that did not find a statistical difference versus placebo. […] These medications, however, are limited by their adverse-effect profile. […] Despite positive results in several studies of PTSD-associated nightmares, topiramate use may be limited because of adverse effects.

• #86 Nightmare Disorder – Causes, Symptoms and Treatment | Apollo Hospitals

  https://www.apollohospitals.com/diseases-and-conditions/nightmare-disorder-causes-symptoms-and-treatment/

  Nightmare disorder is one where recurrent and distressing nightmares occur. […] The exact reason is unexplained. Some causes include: Trauma, Anxiety or stress, Medications, Sleep distress, Depression, Consumption of alcohol and drugs. […] Treatment options may include: Medical treatment: If nightmares are linked to an underlying medical condition, treatment is directed at the underlying condition. Stress or anxiety treatment: Doctors may recommend stress-reduction methods, therapy or counseling with a mental health expert. Imagery rehearsal therapy: Imagery rehearsal therapy is often used with those who have nightmares owing to Post traumatic stress disorder (PTSD). The therapy involves changing the ending to your nightmare remembered while awake so that it does not threaten. Then, you rehearse the new ending in the mind. This approach may decrease the frequency of your nightmares. […] Nightmares cause stress and anxiety disorder, and in rare cases, a patient may need psychiatric treatment. It is a mental state but not a mental illness.

• #87 Management of nightmares in patients with posttraumatic stress disorde | NSS

  https://www.dovepress.com/management-of-nightmares-in-patients-with-posttraumatic-stress-disorde-peer-reviewed-fulltext-article-NSS

  The decision to implement IRT for nightmares should be made within the context of comprehensive treatment of PTSD and coexisting sleep disorders. […] The efficacy of ERRT has been established in multitude of RCTs, case series, and effectiveness studies involving combat veterans, life-threatening accidents, and sexual assault victims with PTSD. […] The underlying mechanisms for the ERRT-observed responses are not well understood, it is posited that nightmare-related imagery leads to defensive reactivity and autonomic arousal which interferes with sleep quality. […] The literature to date on the management of nightmares in PTSD is limited by a paucity of randomized controlled study designs and the use of different measures to assess health care outcomes.

• #88 Nightmares share genetic risk factors with sleep and psychiatric traits | Translational Psychiatry

  https://www.nature.com/articles/s41398-023-02637-6

  the biological basis behind nightmares and the causality between nightmares and psychiatric traits have not been thoroughly established. […] the genetic correlation demonstrated a significant change in p-values between only baseline correction and removing individuals with heavy alcohol consumption. […] insomnia has been linked to numerous psychological and physical disorders. […] the current genetic correlations are computed in nonoverlapping samples (Finnish population vs. UK Biobank) and do not have shared individuals. […] our finding of shared genetic risk between nightmares and symptoms of insomnia would support this hypothesis. […] our findings indicate the possibility that patients with psychiatric disorders may benefit if their nightmares are managed as part of the treatment strategy by using evidence-based interventions such as imagery rehearsal therapy.

• #89 Nightmares share genetic risk factors with sleep and psychiatric traits | Translational Psychiatry

  https://www.nature.com/articles/s41398-023-02637-6

  the biological basis behind nightmares and the causality between nightmares and psychiatric traits have not been thoroughly established. […] the genetic correlation demonstrated a significant change in p-values between only baseline correction and removing individuals with heavy alcohol consumption. […] insomnia has been linked to numerous psychological and physical disorders. […] the current genetic correlations are computed in nonoverlapping samples (Finnish population vs. UK Biobank) and do not have shared individuals. […] our finding of shared genetic risk between nightmares and symptoms of insomnia would support this hypothesis. […] our findings indicate the possibility that patients with psychiatric disorders may benefit if their nightmares are managed as part of the treatment strategy by using evidence-based interventions such as imagery rehearsal therapy.

• #90 Management of nightmares in patients with posttraumatic stress disorde | NSS

  https://www.dovepress.com/management-of-nightmares-in-patients-with-posttraumatic-stress-disorde-peer-reviewed-fulltext-article-NSS

  PTSD and nightmares are intertwined in such a manner that nightmares strengthen PTSD symptoms, and PTSD in turn causes nightmares. […] However, the presence of nightmares not only influences the development of PTSD but also accelerates the progression of PTSD following trauma exposure. […] The distressing nature of these nightmares occasionally results in the display of avoidance behavior before bedtime such as staying late or leaving the lights on at night, which ultimately lead to insomnia and daytime dysfunction. […] One study had linked nightmares to a fivefold increase in suicidality. […] The mechanism by which nightmares confer suicidality has not been identified; however, the common denominator linking these entities together has been ascribed to the sense of entrapment, defeat, and hopelessness.

• #91 Nightmare Disorder in Adults

  https://www.mindyra.com/solutions/adults/nightmare

  Nightmare disorder is a psychiatric disorder that affects approximately 2 -5% of adults. […] Little is known about the neurobiology of nightmare disorder. However, some studies have linked nightmares to various neurotransmitter systems, in particular norepinephrine, serotonin, and dopamine, and to activity in affective neural networks, including the amygdala, hippocampus, medial prefrontal cortex, and anterior cingulate cortex. […] It is not clear if different types of nightmares (e.g., those associated with nightmare disorder versus substance use or withdrawal) share a common underlying pathophysiology. Individuals with nightmare disorder are more likely to endorse a history of adverse events, which may contribute to the incidence of nightmares.

• #92 Management of nightmares in patients with posttraumatic stress disorde | NSS

  https://www.dovepress.com/management-of-nightmares-in-patients-with-posttraumatic-stress-disorde-peer-reviewed-fulltext-article-NSS

  The decision to implement IRT for nightmares should be made within the context of comprehensive treatment of PTSD and coexisting sleep disorders. […] The efficacy of ERRT has been established in multitude of RCTs, case series, and effectiveness studies involving combat veterans, life-threatening accidents, and sexual assault victims with PTSD. […] The underlying mechanisms for the ERRT-observed responses are not well understood, it is posited that nightmare-related imagery leads to defensive reactivity and autonomic arousal which interferes with sleep quality. […] The literature to date on the management of nightmares in PTSD is limited by a paucity of randomized controlled study designs and the use of different measures to assess health care outcomes.

• #93 Nightmare disorder – Wikipedia

  https://en.wikipedia.org/wiki/Nightmare_disorder

  The nightmares may be idiopathic or could be associated with psychiatric disorders like post-traumatic stress disorder, schizophrenia, and borderline personality disorder. Nightmares can also be triggered by stress and anxiety and substance abuse, such as drugs that affect the neurotransmitters norepinephrine and dopamine and serotonin. Nevertheless, causality between drugs such as beta-blockers or alpha-agonists and nightmares is still unclear and further research needs to be done to investigate the biochemical mechanisms of nightmares. […] Eighty percent of patients who have PTSD report nightmares. Patients with PTSD have symptoms that are classified into three clusters: intrusive/re-experiencing, numbing, and hyperarousal. Nightmares are usually considered to be part of the intrusive/re-experiencing symptom.

• #94 Management of nightmares in patients with posttraumatic stress disorde | NSS

  https://www.dovepress.com/management-of-nightmares-in-patients-with-posttraumatic-stress-disorde-peer-reviewed-fulltext-article-NSS

  The decision to implement IRT for nightmares should be made within the context of comprehensive treatment of PTSD and coexisting sleep disorders. […] The efficacy of ERRT has been established in multitude of RCTs, case series, and effectiveness studies involving combat veterans, life-threatening accidents, and sexual assault victims with PTSD. […] The underlying mechanisms for the ERRT-observed responses are not well understood, it is posited that nightmare-related imagery leads to defensive reactivity and autonomic arousal which interferes with sleep quality. […] The literature to date on the management of nightmares in PTSD is limited by a paucity of randomized controlled study designs and the use of different measures to assess health care outcomes.

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